Prevalence of recent intimate partner violence

Export Indicator

Proportion of ever-married or partnered women 15–49 years old who experienced physical or sexual violence from a male intimate partner in the past 12 months
What it measures
Progress in reducing the prevalence of intimate partner violence against women, as an outcome itself and as a proxy for gender inequality
 
An intimate partner is defined as a cohabiting partner, whether or not they were married at the time. The violence could have occurred after they separated.
Rationale
Globally, high rates of HIV infection among women have brought into sharp focus the problem of violence against women. There is growing recognition that deep-rooted, pervasive gender inequalities, especially violence against women and girls, shape their risk of and vulnerability to HIV infection. Violence and HIV have been linked through direct and indirect pathways. Studies in many countries indicate that many women have experienced violence in some form or another at some point in their life. WHO estimates that one in three women globally has  experienced intimate partner violence and/or non-partner sexual violence.
Numerator
Women 15–49 years old who have or have ever had an intimate partner and report experiencing physical or sexual violence from at least one of these partners in the past 12 months. See the numerator explanation below for the specific acts of physical or sexual violence to include.
Denominator

Total number of women 15–49 years old surveyed who currently have or have had an intimate partner

Calculation

Numerator/denominator

Method of measurement
Population-based surveys already being used within countries, such as WHO multicountry surveys, Demographic and Health Surveys or AIDS Indicator Surveys (domestic violence module) and the International Violence against Women Surveys.
 
Collecting data on violence against women requires special methods ensuring that information is gathered in a manner adhering to ethical and safety standards, that does not pose a risk to study participants and maximizes data validity and reliability.
Measurement frequency

3–5 years

Disaggregation
  • Age (15–19, 20–24 and 25–49 years)
  • HIV status (if available)
Explanation of the numerator
Ever-married or -partnered women 15–49 years old include those who have ever been married or have had an intimate partner. They are asked whether they have experienced physical or sexual violence from a male intimate partner in the past 12 months. Physical or sexual violence is determined by asking whether their partner did any of the following:
  • Slapped her or threw something that could hurt her.
  • Pushed or shoved her.
  • Hit her with a fist or something else that could hurt her.
  • Kicked, dragged or beat her up.
  • Choked or burned her.
  • Threatened or used a gun, knife or other weapon against her.
  • Physically forced her to have sexual intercourse against her will.
  • Forced her to do something sexual she found degrading or humiliating.
  • Made her afraid of what would happen if she did not have sexual intercourse.
The numerator includes those reporting at least one incident corresponding to any item in the past 12 months.
Explanation of the denominator

Total number of women 15–49 years old surveyed who currently have or had an intimate partner.

Strengths and weaknesses
This indicator assesses progress in reducing the proportion of women experiencing recent intimate partner violence as an outcome in and of itself. It should also be interpreted as a proxy for gender equality. A change over time in the prevalence of recent violence will indicate a change in the level of gender equality, one of the structural factors driving the HIV epidemic.
 
The indicator focuses on recent intimate partner violence rather than any experience of it, to enable progress to be monitored. Any experience of intimate partner violence would show little change over time, no matter what the level of programming, since the numerator would include the same women as long as they fell into the target age group. Sustained reductions in intimate partner violence are not possible without fundamental
changes in unequal gender norms, relations at the household and community levels, women’s legal and customary rights, gender inequalities in access to health care, education and economic and social resources and male involvement in reproductive and children’s health. Nor is this possible without promoting men’s responsibility for HIV prevention. Changes in this intimate partner violence indicator will measure changes in the status and treatment of women in all societal domains, which directly and indirectly contribute to reduced risk of HIV transmission.
 
Even when WHO ethical and safety guidelines are adhered to and interviews are conducted in privacy, some women will not disclose information. This means that the estimates will probably be more conservative than the actual level of violence in the surveyed population.
 
The complex relationship between violence against women and HIV has been conceptually illustrated in a review of the state of evidence and practice in developing and implementing strategies addressing the intersection of violence and HIV. For more than a decade, research worldwide has documented the link between violence against women and HIV. Studies have demonstrated an association between violence against women and HIV as both a contributing factor for infection and a consequence of infection. This relationship operates through a variety of direct and indirect mechanisms.
  • Fear of violence may keep women from insisting that a male partner whom they suspect is living with HIV use a condom.
  • Fear of intimate partner violence may keep women from disclosing their HIV status or seeking treatment.
  • Forced vaginal penetration increases the likelihood of HIV transmission.
  • Rape is one manifestation of gender inequality and can result in HIV infection, although it represents a minority of cases.
  • Rape and other sexual and physical abuse can result in mental distress that is manifested in high-risk sexual behaviour, increasing the chances of HIV transmission.
Further information
Investing in gender equality: ending violence against women and girls. New York: UN Women; 2010 (http://www.unwomen.org/en/digital-library/publications/2010/1/ending-vio...).
 
WHO, UNAIDS. Addressing violence against women and HIV/AIDS: what works? Geneva: World Health Organization; 2010 (http://www.who.int/reproductivehealth/publications/violence/978924159986...).
 
Programme on International Health and Human Rights, Harvard School of Public Health. Gender-based violence and HIV. Cambridge (MA): Harvard School of Public Health; 2009.
 
Maman S, Campbell J, Sweat MD, Gielen AC. The intersections of HIV and violence: directions for future research and interventions. Soc Sci Med. 2000;50:459–478.
 
WHO, Department of Reproductive Health and Research, London School of Hygiene and Tropical Medicine, South African Medical Research Council. Global and regional estimates of violence against women. Prevalence and health effects of intimate partner violence and non-partner sexual violence.
 
WHO, UNAIDS. 16 ideas for addressing violence against women in the context of the HIV epidemic: a programming tool. Geneva: World Health Organization; 2013 (http://www.who.int/reproductivehealth/publications/violence/vaw_hiv_epid...).
 
Unite with women—unite against violence and HIV. Geneva: UNAIDS; 2014 (http://www.unaids.org/en/resources/documents/2014/20140312_JC2602_UniteW...).
 
World Health Organization and London School of Hygiene and Tropical Medicine. Preventing intimate partner and sexual violence against women: taking action and generating evidence. Geneva: World Health Organization; 2010 (http://www.who.int/reproductivehealth/publications/violence/978924156400...).
 
Dunkle KL, Decker MR. Gender-based violence and HIV: reviewing the evidence for links and causal pathways in the general population and high-risk groups. Am J Reprod Immunol. 2013;69(Suppl. 1):20–26.
 
Adolescents and young women. In: The gap report. Geneva: UNAIDS; 2014 :132–145 (http://www.unaids.org/en/media/unaids/contentassets/documents/unaidspubl...).